... but it appears that I agree, in small part, with Michael Moore.

Moore has completed a movie on the USSA health care system, which was first shown at the Cannes Film Festival recently. It’s gotten a fair amount of press, but Bloomberg’s article, Michael Moore's ‘Sicko’ Slams U.S. Health System; Cannes Claps, is the only one I’ve seen that flatly states Moore’s goal in making Sicko:

“I would rather throw my lot down with the majority of Americans who know that something is wrong and want things to change,” said Moore. He wants the private sector out of the provision of health insurance, he said.

I daresay that most Americans “want things to change” in health care, but that hardly translates into agreement on how they’d like it to change. And there begins my departure from Moore: he wants “universal health coverage”:

Still, as Moore concluded, politician-like, at the press conference, “It is my profound hope that people will listen this time, with this film, because I don't want to wait 10 or 20 years before we have universal health coverage in America.”

The Bloomberg article addresses problems with some of Moore’s glorifying of completely socialized medical systems, but a Toronto Star article, Canadians don't care for Sicko, is very good too. A taste:

Michael Moore is handing out fake bandages to promote his new film Sicko, an exposé of the failings of the U.S. health care system.

But he may feel like applying a couple to himself after the mauling he received yesterday [5/19/07] from several Canadian journalists – present company included – following the film's first viewing at the Cannes Film Festival.

"You Canadians! You used to be so funny!" an exasperated Moore said at a press conference in the Palais des Festivals.

"You gave us all our best comedians. When did you turn so dark?"

We Canucks were taking issue with the large liberties Sicko takes with the facts, with its lavish praise for Canada's government-funded medicare system compared with America's for-profit alternative.

While justifiably demonstrating the evils of an American system where dollars are the major determinant of the quality of medicare care [sic] a person receives, and where restoring a severed finger could cost an American $60,000 compared to nothing at all for a Canadian, Sicko makes it seems as if Canada's socialized medicine is flawless and that Canadians are satisfied with the status quo. ....

Canadian journalists spoke of the long wait times Canadians face for health care, much longer than the few minutes Moore suggests in Sicko. Moore, who has come under considerable fire for factual inaccuracies in his films, parried back with more questionable claims. ....

Sicko doles out fulsome praise for the health care systems of France, Britain and Cuba ...

I’ve written before about my disdain for socialized medicine, particularly calls for universal coverage, but I think I failed to observe then that because the federales are so deeply involved in health care in this country, even private medical insurers today aren’t completely private. Moreover, I think that the bulk of so-called private providers of medical insurance are as Moore described, according to the Bloomberg article—more concerned about maintaining/expanding profits for shareholders than they are about their customers’ health. So, on that basis, yes, I want them out of health care, too.

My preference, as noted many times here, is for insurance to end completely—fee for service is what I want. If there is to be private medical insurance that is successful for both customers and investors, I think an extensive overhaul is needed. Insurance companies today act as gatekeepers, often making life and death decisions for their ostensible customers on the basis of dollars, rather than what is in the insured’s best interest. Customers, having become accustomed to every little thing being covered by insurance, abuse insurance, and abuse themselves as well, since the current insurance system provides disincentives to taking responsibility for one’s own health.

What do I think would work? No insurance coverage for basic and routine medical care, or much more expensive broad policies that align better with typical usage patterns and costs of such policies. That would include the increased administrative costs, of course. Such a step would have several very good effects:
1] helping individuals see the true costs of liberal use of medical insurance;
2] encouraging individuals to learn about and (one would hope) choose healthier habits; and
3] decreasing medical costs, largely through reduced overhead (much lower administrative costs).
Medical insurance that only covered “catastrophic” conditions would likely set premiums determined by the individual’s risk factors for them. Those could include genetic predispositions as well as behavioral contributors, such as smoking or being overweight or having some kind of high-risk job. If one reduces one’s statistical risk factor, one’s premiums would drop. Individuals could pick and choose from a list of conditions they’d want to be insured for. If a customer gets an insured condition, the insurance company pays the contracted amount for whatever care the indivdual wants, up to the stated maximum limit of coverage. Decoupling medical insurance from employment would also be a big improvement.

Those steps would reduce or eliminate a lot of problems in the USSA’s current medical system, but they’re far from complete. Eliminating the effects of numerous medical guilds, other rationers/monopolists, and regulations would also bring huge improvements, but I don’t see that happening any time soon. And I know I left a lot of middle ground unaddressed, such as genuine emergency treatments. I’m not a healthcare expert, nor an economist, and I don’t pretend I have all the answers. But I’m pretty sure my three steps are much too radical to be taken seriously by the medicrats.